Doula Support

This essay demonstrates significant factors, a midwife and the women may face within Australian public hospitals. As a midwife the key skills are understanding of what supports and impacts the normal physiological process of labour and birth. This essay will discuss two influencing factors that have a negative effect on the normal progress of labour and birth. This will be seen, firstly by discussing the cultural and environmental impacts of labour and birth. Then, examining how the midwife may best support and facilitate the adverse effects of normal physiological process. This essay also discusses a positive labour and birth environment within the Australian standard model of care.

Providing an effective care and support to the patient and for their babies during labour

The National Institute for Health and Clinical Excellence (NICE, 2007) Intrapartum guidelines state that during the first stage of labour women should be encouraged to adopt the position they feel most comfortable in. This is what the student was trying to encourage even though her mentor did not.There are various positions the woman can adopt in labour which are generally grouped into upright and recumbent. The positions classed as upright are; standing, walking, kneeling, squatting, on all fours and sitting, and the recumbent position could include; supine, lithotomy, semi-recumbent or side lying (Johnson and Taylor, 2011). The upright position appeared to be more beneficial in Sarah’s case and the author wants to determine if this is always the case. It is evident that sometimes there will be constraints such as continuous fetal monitoring but it is important that the midwife does

Annika the Doula is a full-service doula agency that is located in Northeast, Minneapolis. Annika the Doula is serving the Twin Cities metro area. Their doula services include 2 prenatal visits, unlimited prenatal phone, text and e-mail support, continuous emotional, physical and informational support during the client’s labor, 1-2 postpartum visits, and placenta encapsulation. Annika is a DONA-certified birth doula.

Birth Hands Doula Service is a full-service doula agency that is located in Greensboro, North Carolina. Birth Hands Doula Service serves the Piedmont area of North Carolina including Greensboro, Burlington, Hillsborough, Chapel Hill, and Durham. Their goal is to render a well rounded, woman-centered care throughout the entire pregnancy, birth, and early postpartum. This care constitutes education, advocacy, emotional, and physical support for the women, the parents, their families, and their desired support team. Their services include labor and birth support, birth plan consultation, birth partner support, recording the client’s birth story, blessingway or baby shower celebration, and postpartum support services. The doula of Birth Hands

Northeast Doulas is a full-service doula agency that is located in Minneapolis, Minnesota. Their doula package includes an interview with the doula to make sure they'd be a good fit, 1-2 prenatal visits to talk about their plans, the client’s "dream birth", help with any fears the client may have surrounding labor, and to make sure the client’s partner feels comfortable with the doula’s presence, plus more. The principal of Northeast Doulas, Megan Sharbono is a certified birth doula, certified lactation educator counselor, and certified placenta preparer.

As a doula, I provide educational, physical, and emotional support to clients in a unique and customizable manner. This past year I have continued my education and gained valuable experience by supporting multiple families throughout pregnancy, childbirth, and into postpartum.

There is a wide range of what a Labor and Delivery Registered Nurse can provide, such as planning a care system, taking vitals, monitoring patients, teaching them to care for their newborn, performing tests, recording, and charting information about patients, helping deliver a baby, and consulting with staff; just to name a few.

For hundred of years, women have wrestled with their womanhood, bodies, and what it means to be a woman in our society. Being a woman comes with a wonderful and empowering responsibility--giving birth. What sets us aside from other countries is that the process and expectations of giving birth has changed in our society; coming from midwifery, as it has always been since the early times, to hospitals where it is now expected to give birth at. Midwifery was a common practice in delivering babies in

As of 2013, around 353,000 babies were born in one day, according to the United Nations Children’s Fund (Be Fruitful and Multiply). Delivering babies is very difficult and strenuous, luckily labor and delivery nurses are trained to help care for the mother during the process of welcoming her newborn into the world safely. Labor and delivery nurses play a very crucial role in helping the delivery of babies and bringing safety and peace to the mother. I am choosing to pursue a career as a labor and delivery nurse because they get to provide care to babies, they get paid well, and they get to assist in the delivery process.

Next, a non-hospital birth usually has midwifery or Doula. Midwifery is a profession in which providers take care of pregnant women during her labor and birth and during the postpartum period. Assisting the mother with the child after it is born. According to “Human Sexuality: Diversity in Contemporary America,” midwives attends the majority of births. Midwives are qualified for routine deliveries and minor medical emergencies; often operating as part of a medical term. As Cara Muhlhahn, a certified nurse midwife stated in “Business of Being Born,” she would rather be in the home of the patient so she would feel comfortable. And most women who have midwives are comfortable because they are in the privacy of their own home giving birth to their child and they feel empowered instead of the powerless vibe in a hospital. A Doula, on the other hand, does not have to make clinical decisions. Doulas offer emotional support and manage pain using massage, acupressure, and birthing positions; making it easier for the mother to cope with her complications. According to “Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth,” a Doula is a Greek word that literally means a woman who has experience that can help other women. Klaus Kennell and others who have researched the effects of the doula's presence during childbirth have come to define the term as a woman with experience in childbirth who will give the laboring mother emotional, physical and

Critique of Borders et al.’s Study (2013) “Midwives’ Verbal Support of Nulliparous Women in Second-Stage Labor”

Providing continuous physical and emotional support during labour can reducing maternal fear, stress, and anxiety and protect physiological birth (Steen, 2012). Research shows that fear and anxiety during labour and birth can be detrimental to physiological birth. An environment that women feel unsafe in may stimulate a surge of neuro-hormones that can influence both fetal and maternal physiology, causing irregularity of contractions, fetal distress and subsequent medical inteverntions (Fahy & Parratt, 2006). Conversly, maintaining an environment where women feel safe, protected and supported can facilitate favourable physiological performance (Fahy & Parratt, 2006). Midwives can do this by giving women one-on-one continuous support and placing her at the centre of care throughout childbirth (Steen, 2012). As observed in practice, by constantly reassuring the woman about her progress, her baby’s health and addressing any of her concerns, the midwife can provide a calm and relaxing environment that is conducive to the labouring woman (Buckley, 2015; Steen, 2012). The midwife worked with the woman, encouraging her throughout labour and birth by telling her that she was doing extremely well. The midwife also breathed in-tune with the woman while giving her a back massage, inducing a sense of comfort. The atmosphere was calm and this contributed to the woman garnering confidence in her ability to avoid medical pain relief. Downe (2008) noted that the positive impact of

Pharmacological comfort measures can provide partial or complete pain relief. The epidural is the most efficient way of reducing labor pain. Opioids can be given continuously or in intermittent doses at the patient 's request or through the patient controlled pump. There is the potential for these drugs to have some effect on the fetus, such as breathing difficulties that may require assistance through the use of Narcan. Providing pain relief during the labor process is solely the patient’s choice, and as the nurse only support and encouragement should be given for however she chooses to handle the pain. (Jansen, Gibson, Bowles, & Leach, 2013)

In many U.S. hospitals today the patient care that women receive during management of labor and delivery doesn’t look very evidenced based. Electronic fetal heart rate monitoring (EFM) is the most common form of intrapartal fetal assessment in the United States. We continue to see widespread use of EFM in low risk pregnancies. Electronic fetal monitoring is standard procedure despite numerous randomized controlled trials that have disproven its validity. It is routinely used, yet does not decrease neonatal morbidity or mortality compared to the use of intermittent auscultation. Intermittent auscultation of the fetal heart rate is an acceptable option for low-risk laboring women, yet it is underutilized in the hospital setting. Several expert organizations have proposed the use of intermittent auscultation as a means of promoting physiologic childbirth. So why do we use continuous EFM in the low risk pregnancy and what does the best evidence support and how can nurses apply the best available evidence to practice? As a patient advocate it is the nurses responsibility to answer these questions and provide the low-risk pregnant woman with current evidence about options for fetal heart rate assessment during labor.